Eureka Medical LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D030648 Issued in MO

Legal business name

EUREKA MEDICAL LLC

Practice address

97 Hill Top Village Center
Suite E & F
Eureka, MO 63025-1184

Phone

(636) 938-6060

Fax

(636) 587-9712

NPI assigned

Sep 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Lawrence Pittenger, D.O.NPI 1629173398

Title

Controling Owner

Phone

(636) 938-6060

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Lawrence Pittenger, D.O.

  • Family Medicine Physician
  • Eureka, MO
  • NPI 1629173398
  NPD (past) Authorized official
• John J Dubois, D.O.

  • Internal Medicine Physician
  • Eureka, MO
  • NPI 1538264205
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1194820860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 HILL TOP VILLAGE CENTER",
            "address_2": "SUITE E & F",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251184",
            "telephone_number": "636-938-6060",
            "fax_number": "636-587-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 HILL TOP VILLAGE CENTER",
            "address_2": "SUITE E & F",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251184",
            "telephone_number": "636-938-6060",
            "fax_number": "636-587-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUREKA MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "PITTENGER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "CONTROLING OWNER",
        "authorized_official_telephone_number": "636-938-6060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "D030648",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2002004657",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501125900",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John J Dubois, D.O.
• Angela D Duesing
• Lisa Durham, O.D.
• Brittany Nichole Eaton, NP
• Eureka Fire Protection District of St. Louis County
• Eureka Pain Clinic LLC
• Eureka Pediatrics
• Eureka Physical Therapy
• Eureka Play Therapy
• Eureka Smiles

• Family Medicine Physician in Eureka, MO
• Providers in Eureka, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.